Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Effect of Systemic Isotretinoin Treatment on Depression and Other Psychological Symptoms: A Case-Control Study
Sistemik İzotretinoin Tedavisinin Depresyon ve Diğer Psikolojik Belirtiler Üzerine Etkisi: Bir Vaka Kontrol Çalışması
Türkan Tuğba YILDIZa , Mehmet MELİKOĞLUb , Zeynep UTLUa, Halil ÖZCANc
aDepartment of Dermatology and Venereology, University of Health Sciences Erzurum City Hospital, Erzurum, Türkiye
bDepartment of Dermatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
cDepartment of Psychiatry, Atatürk University Faculty of Medicine, Erzurum, Türkiye
Turkiye Klinikleri J Dermatol. 2023;33(1):7-13
doi: 10.5336/dermato.2022-92292
Article Language: EN
Full Text
ABSTRACT
 Objective: Isotretinoin is highly preferred in the treatment of severe and resistant acne, but there are still disagreements about whether it has psychogenic side effects. In this study; we aim to investigate the changes in psychological symptoms before and after the treatment in a group of patients treated with isotretinoin. Material and Methods: A total of 110 patients who had moderate or severe acne, and decided to start isotretinoin treatment, were included. Acne Quality of Life Scale, Beck Depression Inventory (BDI), Beck Suicidal Ideation Scale, and Symptom Check List (SCL-90-R) Psychological Symptom Screening tests were performed and compared before starting treatment and at the 6th month of treatment. Results: In our study, in both the pre-treatment and post-treatment groups, the rate of patients at risk for depression was significantly higher in the group that had severe acne (p<0.05). The scores of psychiatric tests with moderate acne were found to be significantly lower than those with severe acne in all parameters (p<0.05). We have found that somatization, depression, phobic thoughts, and general symptom index scores were significantly higher in women before and after the treatment (p<0.05). Acne treatment was associated with improved quality of life and BDI scores in both male and female patients (p=0.001). SCL-90-R somatization, obsession, depression, sensitivity, anger, and general symptom index scores decreased significantly after the treatment. Conclusion: Our study objectively demonstrated that isotretinoin treatment does not cause depression and psychological symptoms, and even improves depression and psychological symptoms caused by acne and improves the quality of life.

Keywords: Acne; isotretinon; depression
ÖZET
 Amaç: İzotretinoin, şiddetli ve dirençli akne tedavisinde oldukça fazla tercih edilmekle birlikte psikojenik yan etkilerinin olup olmadığı konusunda hâlen görüş ayrılıkları bulunmaktadır. Bu çalışmada; izotretinoin ile tedavi edilen bir grup hastada tedavi öncesi ve sonrası psikolojik belirtilerdeki değişiklikleri araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya orta veya şiddetli aknesi olan ve izotretinoin tedavisine başlamaya karar veren toplam 110 hasta dâhil edildi. Akne Yaşam Kalitesi Ölçeği, Beck Depresyon Envanteri [Beck Depression Inventory (BDI)], Beck İntihar Düşüncesi Ölçeği ve Belirti Tarama Listesi [Symptom Check List (SCL-90-R)] Psikolojik Belirti Tarama testleri tedaviye başlamadan önce ve tedavinin 6. ayında karşılaştırıldı. Bulgular: Çalışmamızda hem tedavi öncesi hem de tedavi sonrası gruplarda şiddetli aknesi olan grupta depresyon riski taşıyan hasta oranı anlamlı olarak daha yüksekti (p<0,05). Orta derecede aknesi olan hastalarda psikiyatrik test puanları şiddetli aknesi olanlara göre anlamlı olarak düşük bulundu (p<0,05). Kadınlarda somatizasyon, depresyon, fobik düşünceler ve genel semptom indeksi puanlarının tedavi öncesi ve sonrası anlamlı olarak yüksek olduğunu bulduk (p<0,05). Akne tedavisi, hem erkek hem de kadın hastalarda yaşam kalitesi ve BDI skorlarında iyileşme ile ilişkilendirildi (p=0,001). SCL-90-R somatizasyon, obsesyon, depresyon, duyarlılık, öfke ve genel semptom indeks puanları tedavi sonrasında anlamlı olarak azaldı. Sonuç: Çalışmamız, izotretinoin tedavisinin depresyon ve psikolojik belirtilere neden olmadığını, hatta akneye bağlı gelişen depresyon ve psikolojik belirtileri düzelttiğini ve yaşam kalitesini iyileştirdiğini objektif olarak göstermiştir.

Anahtar Kelimeler: Akne; izotretinoin; depresyon
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